Antimicrobial-resistant strains of Streptococcus pneumoniae have become one of the greatest challenges to global public health today and inappropriate use of antibiotics and high level of antibiotic use is probably the main factor driving the emergence of resistance worldwide. The aim of this study is, therefore, to assess the antimicrobial resistance profiles and multidrug resistance patterns of S. pneumoniae isolates from patients suspected of pneumococcal infections in Ethiopia. A hospital-based prospective study was conducted from January 2018 to December 2019 at Addis Ababa city and Amhara National Region State Referral Hospitals. Antimicrobial resistance tests were performed from isolates of S. pneumoniae that were collected from pediatric and adult patients. Samples (cerebrospinal fluid, blood, sputum, eye discharge, ear discharge, and pleural and peritoneal fluids) from all collection sites were initially cultured on 5% sheep blood agar plates and incubated overnight at 37 °C in a 5% CO2 atmosphere. Streptococcus pneumoniae was identified and confirmed by typical colony morphology, alpha-hemolysis, Gram staining, optochin susceptibility, and bile solubility test. Drug resistance testing was performed using the E-test method according to recommendations of the Clinical and Laboratory Standards Institute. Of the 57 isolates, 17.5% were fully resistant to penicillin. The corresponding value for both cefotaxime and ceftriaxone was 1.8%. Resistance rates to erythromycin, clindamycin, tetracycline, chloramphenicol and trimethoprim-sulfamethoxazole were 59.6%, 17.5%, 38.6%, 17.5 and 24.6%, respectively. Multidrug resistance (MDR) was seen in 33.3% isolates. The most common pattern was co-resistance to penicillin, erythromycin, clindamycin, and tetracycline. Most S. pneumoniae isolates were susceptible to ceftriaxone and cefotaxime. Penicillin has been used as a drug of choice for treating S. pneumoniae infection. However, antimicrobial resistance including multidrug resistance was observed to several commonly used antibiotics including penicillin. Hence, it is important to periodically monitor the antimicrobial resistance patterns to select empirical treatments for better management of pneumococcal infection.

中文翻译：

---

埃塞俄比亚疑似肺炎球菌感染患者的肺炎链球菌分离株的抗菌素耐药性概况和多药耐药模式

肺炎链球菌耐药菌株已成为当今全球公共卫生面临的最大挑战之一，不当使用抗生素和高水平使用抗生素可能是推动全球耐药性出现的主要因素。因此，本研究的目的是评估埃塞俄比亚疑似肺炎球菌感染患者的肺炎链球菌分离株的抗菌素耐药性和多药耐药模式。2018 年 1 月至 2019 年 12 月在亚的斯亚贝巴市和阿姆哈拉国家地区州立转诊医院进行了一项基于医院的前瞻性研究。对从儿童和成人患者身上收集的肺炎链球菌分离株进行了抗菌素耐药性测试。样本（脑脊液、血液、痰液、眼分泌物、耳分泌物、来自所有采集点的胸水和腹膜液）最初在 5% 羊血琼脂平板上培养，并在 37 °C 和 5% CO2 气氛中培养过夜。肺炎链球菌通过典型的菌落形态、α-溶血、革兰氏染色、optochin 敏感性和胆汁溶解度测试被鉴定和证实。根据临床和实验室标准协会的建议，使用 E-test 方法进行耐药性测试。在 57 个分离株中，17.5% 对青霉素完全耐药。头孢噻肟和头孢曲松的相应值为 1.8%。对红霉素、克林霉素、四环素、氯霉素和甲氧苄啶-磺胺甲恶唑的耐药率分别为59.6%、17.5%、38.6%、17.5%和24.6%。在 33.3% 的分离株中观察到多药耐药性 (MDR)。最常见的模式是对青霉素、红霉素、克林霉素和四环素的共同耐药。大多数肺炎链球菌分离株对头孢曲松和头孢噻肟敏感。青霉素已被用作治疗肺炎链球菌感染的首选药物。然而，观察到对包括青霉素在内的几种常用抗生素的抗菌素耐药性，包括多药耐药性。因此，定期监测抗菌素耐药性模式以选择经验性治疗方法以更好地管理肺炎球菌感染非常重要。观察到对包括青霉素在内的几种常用抗生素的抗菌素耐药性，包括多药耐药性。因此，定期监测抗菌素耐药性模式以选择经验性治疗方法以更好地管理肺炎球菌感染非常重要。观察到对包括青霉素在内的几种常用抗生素的抗菌素耐药性，包括多药耐药性。因此，定期监测抗菌素耐药性模式以选择经验性治疗方法以更好地管理肺炎球菌感染非常重要。